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LONGSHORE DIVISION CONVENTION/CAUCUS RESOLUTION TEMPLATE

LOCAL 63 Template for ILWU Convention/Longshore Division Caucus:

(Below.  Please complete, sign, and submit to the Local 63 Business Office):

• RESOLUTION TEMPLATE BLANK ONLY  (Word Version)

MEDICAL/WELFARE:

• Americans with Disabilities Act (ADA)  
• ADA Packet
• Chiropractic Benefit
• Chiropractic Benefit
• Coastwise Indemnity Enrollment Form
• Coastwise Indemnity Plan Enrollment Form
• Coastwise Indemnity Plan
• ILWU-PMA Coastwise Indemnity Plan Summary Description
• COVID-19
• 2020-ILWU-PMA-COVID-19-Vacation-Advance-Request-Form-highlighted
• CLRC-29-20-Questions-and-Answers-Re-Advancing-Vacation-Time-for-Paid-Sick-Leave-highlighted
• Dental
• ILWU-PMA Welfare Plan Dental Program Choice Form
• Description of Diabetic Durable Equipment Benefit & Claim Form
• Diabetic Durable Equipment Claim Form
• Hearing Aid Program
• Hearing Aid Claim Form
• Medicare Claim Form for Supplemental Hospital, Medical, Surgical Benefits
• ILWU-PMA Welfare Plan Medicare Claim Form For Supplemental Hospital, Medical, Surgical Benefits
• Medicare Part B – Enrollment Questionairre
• Medicare Part B – Enrollment Questionnaire
• Subsequent Prosthetic Device Benefit Claim Form
• Subsequent Prosthetic Device Benefit Claim Form
• Supplemental CSDI Form
• ILWU-PMA Welfare Plan Supplemental CSDI Disability Claim Form
• Vision
• Vision Service Plan Benefit Description
• Ophthamology Benefit

PENSION

• Normal Retirement Packet
• Normal Retirement Packet
• Disability Retirement Packet
• Disability Retirement Packet

MISCELLANEOUS FORMS

• Beneficiary Designation Form
• ILWU-PMA Welfare Plan Beneficiary Designation Form
• Dependent Child Certification Form
• Dependent Child Certification Form
• Federal Election Form
• Federal Election Form
• State of California Election Form
• State of California Election Form
• Same Sex Domestic  Partner Certification Form
• Same Sex Domestic Partner Certification Form
• Sixty (60)+ Request to be Excused from all Membership Meetings
• Member Excuse From Meeting Form
• Tower-Only Age Exemption (Night-Side Only)
• Tower Only Age Exemption Form – Nightside Only

UNION COMPLAINTS

• Union Complaint Form

LOCAL 63 TIME CARD

• Time Card
• SAMPLE TIME CARDS (below):
• 07-31-2017 Two Sample Time Cards

PCCCD SECTION 13.2 GRIEVANCES:

• CLRC 09-22 – Section 13.2 Procedures – Covid-19 Health Crisis
• CLRC 09-22 – Section 13.2 Complaint Form
• CLRC 02-22 – Section 13.2 Procedures – Covid-19 Health Crisis
• CLRC 02-22 – 13.2 Complaint Form
• CLRC 75-20-Section 13.2 Grievance Form-Covid-19 Health Crisis
• CLRC 75-20 Meeting Minutes-Section 13.2 Procedures-Covid-19 Health Crisis